甲砜霉素联合维胺酯治疗寻常性银屑病疗效观察

目的：观察甲砜霉素联合维胺酯治疗寻常性银屑病的疗效及安全性。方法：选择寻常性银屑病80例,随机分为观察组与对照组各40例。对照组采用常规氯雷他定分散片口服及丁酸氢化可的松乳膏外用治疗;观察组在上述治疗基础上,加用甲砜霉素联合维胺酯胶囊治疗。均4周为1个疗程。治疗2个疗程后,比较两组疗效及治疗前后血清肿瘤坏死因子（TNF-α）和白介素4（IL-4）水平变化情况。结果：观察组痊愈12例,显效15例,有效4例,无效9例,总有效率77.5%;对照组痊愈8例,显效9例,有效7例,无效16例,总有效率60.0%;观察组总有效率显著高于对照组（P〈0.05）。观察组TNF-α水平较对照组降低非常显著（P〈0.01）,IL-4水平较对照组升高非常显著（P〈0.01）。结论：甲砜霉素联合维胺酯胶囊治疗寻常性银屑病疗效较好,且较安全。     

复方氟米松软膏治疗银屑病的近期临床疗效观察

目的评价复方氟米松软膏外用治疗斑块状银屑病的近期疗效。方法对符合入选标准的69例斑块型银屑病患者,采用随机数字法将肢体左或右侧的靶皮损分为治疗组和对照组,治疗组给予复方氟米松软膏外用,2次/d,4周为1个疗程。对照组给予复方丙酸氯倍他索软膏外用,方法及疗程同治疗组。结果 64例完成实验,治疗组D14、D28时SSR I为0.65±0.21与0.91±0.32;痊愈率D14为35.94%,D28为60.94%;总有效率D14为92.19%,D28为93.75%;与对照组相比均无统计学差异(P>0.05)。结论复方氟米松与复方丙酸氯倍他索在治疗稳定期寻常型银屑病时疗效相仿,均具有较好的临床疗效。     

卡泊三醇联合复方丙酸氯倍他索软膏治疗银屑病的近期疗效观察

目的探讨卡泊三醇软膏联合复方丙酸氯倍他索软膏外用治疗银屑病的近期临床疗效。方法采用随机、开放、平行自身对照试验。将符合入选标准的93例慢性斑块型银屑病患者的皮损沿躯干中线分为左右两侧,采用随机数字法决定一侧躯干及肢体皮损为治疗组,给予外用复方卡泊三醇软膏,2次/d,复方丙酸氯倍他索软膏,1次/d,4周为1个疗程,与治疗部位相对应的另一侧躯干及肢体皮损为对照组,涂用丙酸氯倍他索软膏,2次/d,他扎罗汀乳膏,1次/d,疗程同治疗组。同时给予患者口服维生素C 0.2,3次/d,叶酸10 mg,3次/d,郁金银屑片0.96,3次/d,窄谱中波紫外线治疗1次/3 d。治疗前及治疗开始后每2周评估患者的症状积分,计算患者的症状积分指数(SSRI),评价治疗效果。结果共有79例患者完成试验,治疗组D14、D28时SSRI分别为0.81±0.23与0.92±0.11,与对照组(0.53±0.17、0.64±0.23)相比差异均有统计学意义(均P<0.05);治疗组痊愈率D14为63.29%,D28为78.48%,与对照组(分别为39.24%、50.63%)相比差异有统计学意义(均P<0.05);总有效率治疗组在D14为94.94%,D28为97.47%,与对照组相比较(D14为65.82%,D28为72.15%)差异均有统计学意义(均P<0.05)。结论卡泊三醇软膏联合复方丙酸氯倍他索软膏外用治疗寻常型银屑病具有肯定的疗效,未发现严重不良反应。     

复方丙酸氯倍他索软膏治疗寻常型银屑病

目的：观察复方丙酸氯倍他索软膏（含0．05％丙酸氯倍他索和0．025％全反式维甲酸）外用治疗寻常型银屑病的疗效和安全性。方法：采用随机、双盲、平行对照试验。72例寻常型银屑病随机分入治疗组（复方丙酸氯倍他索软膏），对照1组（0．02％丙酸氯倍他索霜）及对照2组（0．025％全反式维甲酸霜）。每组每天用药2次，连续治疗4周。试验结束后观察主、客观各项指标的变化，并进行统计学分析。结果：4周后治疗组痊愈率62．50％，有效率95．83％，与对照1组及对照2组均有显著性差异，无不良反应发生。结论：复方丙酸氯倍他索软膏外用治疗寻常型银屑病安全、有效。     

自拟中药汤剂熏洗联合毫火针治疗湿热内蕴型掌跖脓疱病疗效观察

【摘要】 目的 对比分析自拟中药汤剂熏洗联合毫火针与单纯自拟中药汤剂熏洗治疗湿热内蕴型掌跖脓疱病的临床疗效。方法 选取 2018年1月至2019 年11月许昌中医院收治的 75 例湿热内蕴型掌跖脓疱病患者作为研究对象,并按照随机数表法将其随机分为观察组 (38 例) 与对照组 (37 例),观察组患者行自拟中药汤剂熏洗联合毫火针治疗,对照组患者单纯行自拟中药汤剂熏洗治疗, 对比观察两组患者治疗 8 周后的改良银屑病皮损面积和严重程度指数 (PASI) 评分及临床疗效。结果 治疗 8 周后, 两组患者改良 PASI 评分均明显降低,且观察组患者的改良 PASI 评分 [ (1. 54 ± 0. 98) 分] 明显低于对照组 [ (2. 17 ± 1. 19) 分] (t = 2. 506, P = 0. 015);治疗 8 周后, 观察组患者中痊愈 21 例、显效 10 例、有效 5 例、无效 2 例,总有效率为 94. 74%,明显优于对照组患者的痊愈 12 例、显效 10 例、有效 9 例、无效 6 例,总有效率 83. 78% (Z = - 2. 322,P = 0. 020)。结论 自拟中药汤剂联合毫火针可有效促进湿热内蕴型掌跖脓疱病患者的皮损消退,疗效明显优于单纯应用自拟中药汤剂治疗,具有较高的临床应用价值。     

钙泊三醇倍他米松软膏治疗掌跖角化性湿疹疗效观察

目的观察钙泊三醇倍他米松软膏治疗掌跖角化性湿疹的疗效。方法 106例掌跖角化性湿疹随机分为对照组和治疗组,治疗组外用钙泊三醇倍他米松软膏,1次/d;对照组外用卤米松乳膏,2次/d。两组均治疗6周,随访2个月观察有效率。结果治疗组和对照组的有效率分别为77.8%和57.7%,差异有统计学意义(P<0.05),复发率分别为14.8%和36.5%,差异有统计学意义(P<0.05)。结论钙泊三醇倍他米松软膏治疗掌跖角化性湿疹疗效显著,复发率低。     

甲真菌病的激光治疗

正目的:评估点阵CO_2激光联合外用盐酸特比萘芬乳膏治疗甲真菌病的疗效及安全性,并探讨影响疗效的相关因素。方法:募集甲真菌患者31例,根据不同临床类型、病甲位置、感染菌种等对病甲进行分组,采用点阵CO_2激光治疗,每2周治疗1次,共治疗12次。同时每晚予盐酸特比萘芬乳膏外用封包于患甲,疗程共6个月。观察治疗后即刻、     

中药熏洗联合湿润烧伤膏治疗掌跖脓疱病疗效观察

目的对比观察自拟中药汤剂熏洗联合湿润烧伤膏治疗掌跖脓疱病的临床疗效。方法将2017年3月至2017年12月黑龙江中医药大学附属第二医院皮肤科治疗的60例掌跖脓疱病患者随机分为治疗组(30例)与对照组(30例),其中治疗组患者局部皮损创面采用自拟中药汤剂熏洗联合湿润烧伤膏治疗,对照组患者局部皮损创面单纯采用自拟中药汤剂熏洗治疗, 8周后对比观察两组患者的治疗效果。结果治疗8周后,治疗组患者皮损评分为(1.86±2.11)分、治疗总有效率为93.3%,对照组患者皮损评分为(3.80±2.84)分、治疗总有效率为76.7%,两组对比,P均0.01,差异具有统计学意义。结论中药熏洗联合湿润烧伤膏治疗掌跖脓疱病,可有效缓解局部瘙痒、疼痛等症状,促进疱液吸收、创面愈合,疗效显著。     

糖皮质激素联合阿维A治疗重症银屑病临床疗效与安全性评价

目的评价糖皮质激素联合阿维A治疗重症银屑病的临床疗效与安全性。方法30例重症银屑病患者采用糖皮质激素联合阿维A治疗,平均疗程8周。结果糖皮质激素联合阿维A治疗红皮病型银屑病、泛发性脓疱型银屑病、掌跖脓疱病有效率分别为80％、88．2％、100％;且糖皮质激素和可维A治疗剂量与副作用有相关性。结论糖皮质激素联合阿维A治疗重症银屑病临床疗效显著,长时间用于临床监测下服用糖皮质激素和阿维A未出现严重的毒副作用。     

清肺解毒消痤方加减联合红、蓝光治疗脓疱型痤疮临床研究

 目的 观察清肺解毒消痤方加减口服和面膜外用并联合红、蓝光照射治疗脓疱型痤疮的效果.方法 将88例脓疱型痤疮患者分为2组:治疗组46例,予以清肺解毒消痤方加减口服和面膜外用并联合红、蓝光照射;对照组42例,仅予以清肺解毒消痤方加减口服和面膜外用,6周后进行疗效评定与对比.结果 治疗组痊愈率80.43％,总有效率93.47％;对照组痊愈率和总有效率分别为59.52％,78.57％.二者比较差异均有统计学意义(x2 =4.61,P＜o.05;x2=4.14,P＜ 0.05).结论 清肺解毒消痤方加减口服和面膜外用并联合红、蓝光照射治疗脓疱型痤疮有较好疗效,且操作简便,不良反应少.     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.